停止门诊输液前后儿科细菌性肺炎患者炎性指标变化情况

The changes of inflammatory indexes of pediatric bacterial pneumonia patients before and after cessation of infusion

目的探讨停止门诊输液前后儿科细菌性肺炎患者降钙素原（PCT）、超敏c反应蛋白（hs—CRP）、白细胞（WBC）、中性粒细胞比例（GN％）变化情况及临床价值。方法选取停止门诊输液前后资料完整儿科细菌性肺炎患者各91例，依次分为对照组和研究组，采用罗氏cobase601检测PCT和hs—CRP，希森美康XS—1000i检测WBC和GN％，上述指标阳性率和变化趋势比较。结果调查所用的检测系统精密度、准确度良好。研究组上述各指标阳性率和数值明显提高，差异有统计学意义（P〈0．05），说明过度输液现象有所节制。研究组PCT从第1d到第7d逐渐降低，差异有统计学意义（P〈0．01），hs—CRP第1d升高不明显，从第2d到第7d逐渐降低，差异有统计学意义（P〈0．05），WBC和GN％第1d到第7d有所降低，但差异无统计学意义（P〉0．05）。结论停止门诊输液效果明显，可以继续推广。PCT可用于儿科细菌性肺炎患者诊断和用药监测指标，hs—CRP次之，WBC和GN％欠佳。

Objective To explore changes and clinical value of procalcitonin （PCT）, hypersensitive C-reactive protein （hs-CRP）, white blood cells （WBC）, and neutrophile granulocyte percentage （GN%） of pediatric bacterial pneumonia patients before and after cessation of infusion. Methods 91 pediatric bacterial pneumonia patients with complete data before and after cessation of infusion were collected respectively, which were as the control group and the research group. Roche cobas e 601 was used to detect PCT and hs- CRP, Sysmex xs-1000i was used to detect WBC and GN%, the positive rate and variation trend of the above indicators were compared. Results The accuracy and precision of the detecting system were good. The level and the positive rate of the above indicators in the study group were significantly higher （P〈0.05）, which showed that excessive transfusion was in moderation. The level of PCT in the study group gradually decreased from the 1st day to the 7th day （P〈0.01）; the level of hs-CRP did not increase obviously, gradually decreased from the 2rd day to the 7th day （P〈0.05）; the levels of WBC and GN% slightly decreased from the 1st day to the 7th day （P〉0.05）. Conclusion Cessation of outpatient transfusion has obvious effect, can be promoted continually. PCT can be used for diagnosis and drug monitoring for pediatric bacterial pneumonia, and hs-CRP secondary, WBC and GN% are not good.